PMID- 37721580
OWN - NLM
STAT- MEDLINE
DCOM- 20240109
LR  - 20240116
IS  - 1619-7089 (Electronic)
IS  - 1619-7070 (Linking)
VI  - 51
IP  - 2
DP  - 2024 Jan
TI  - Baseline [(18)F]FDG PET features are associated with survival and toxicity in 
      patients treated with CAR T cells for large B cell lymphoma.
PG  - 481-489
LID - 10.1007/s00259-023-06427-6 [doi]
AB  - PURPOSE: Chimeric antigen receptor (CAR) T cells have established themselves as 
      an effective treatment for refractory or relapsed large B cell lymphoma (LBCL). 
      Recently, the sDmax, which corresponds to the distance separating the two 
      farthest lesions standardized by the patient's body surface area, has appeared as 
      a prognostic factor in LBCL. This study aimed to identify [(18)F]FDG-PET 
      biomarkers associated with prognosis and predictive of adverse events in patients 
      treated with CAR T cells. METHODS: Patients were retrospectively included from 
      two different university hospitals. They were being treated with CAR T cells for 
      LBCL and underwent [(18)F]FDG-PET just before CAR T cell infusion. Lesions were 
      segmented semi-automatically with a threshold of 41% of the maximal uptake. In 
      addition to clinico-biological features, sDmax, total metabolic tumor volume 
      (TMTV), SUVmax, and uptake intensity of healthy lymphoid organs and liver were 
      collected. Progression-free survival (PFS) and overall survival (OS) were 
      estimated using the Kaplan-Meier method. The occurrence of adverse events, such 
      as cytokine release syndrome (CRS) and immune effector cell-associated 
      neurotoxicity syndrome (ICANS), was reported. RESULTS: Fifty-six patients were 
      included. The median follow-up was 9.7 months. Multivariate analysis showed that 
      TMTV (cut-off of 36 mL) was an independent prognostic factor for PFS (p < 0.001) 
      and that sDmax (cut-off of 0.15 m(-1)) was an independent prognostic factor for 
      OS (p = 0.008). Concerning the occurrence of adverse events, a C-reactive protein 
      level > 35 mg/L (p = 0.006) and a liver SUVmean > 2.5 (p = 0.027) before CAR T 
      cells were associated with grade 2 to 4 CRS and a spleen SUVmean > 1.9 with grade 
      2 to 4 ICANS. CONCLUSION: TMTV and sDmax had independent prognostic values, 
      respectively, on PFS and OS. Regarding adverse events, the mean liver and spleen 
      uptakes were associated with the occurrence of grade 2 to 4 CRS and ICANS, 
      respectively. Integrating these biomarkers into the clinical workflow could be 
      useful for early adaptation of patients management.
CI  - (c) 2023. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, 
      part of Springer Nature.
FAU - Marchal, E
AU  - Marchal E
AUID- ORCID: 0000-0001-7165-4755
AD  - Department of Nuclear Medicine, Amiens-Picardie University Hospital, Amiens, 
      France. marchal.etienne@chu-amiens.fr.
FAU - Palard-Novello, X
AU  - Palard-Novello X
AD  - Department of Nuclear Medicine, University Rennes, CLCC Eugene Marquis, INSERM, 
      LTSI-UMR 1099, Rennes, France.
FAU - Lhomme, F
AU  - Lhomme F
AD  - Department of Clinical Hematology, Rennes University Hospital, Rennes, France.
FAU - Meyer, M E
AU  - Meyer ME
AD  - Department of Nuclear Medicine, Amiens-Picardie University Hospital, Amiens, 
      France.
FAU - Manson, G
AU  - Manson G
AD  - Department of Clinical Hematology, Rennes University Hospital, Rennes, France.
FAU - Devillers, A
AU  - Devillers A
AD  - Department of Nuclear Medicine, CLCC Eugene Marquis, Rennes, France.
FAU - Marolleau, J P
AU  - Marolleau JP
AD  - Department of Hematology, Amiens-Picardie University Hospital, Amiens, France.
FAU - Houot, R
AU  - Houot R
AD  - Department of Clinical Hematology, Rennes University Hospital, Rennes, France.
FAU - Girard, A
AU  - Girard A
AD  - Department of Nuclear Medicine, Amiens-Picardie University Hospital, Amiens, 
      France.
LA  - eng
PT  - Journal Article
DEP - 20230918
PL  - Germany
TA  - Eur J Nucl Med Mol Imaging
JT  - European journal of nuclear medicine and molecular imaging
JID - 101140988
RN  - 0Z5B2CJX4D (Fluorodeoxyglucose F18)
RN  - 0 (Biomarkers)
SB  - IM
MH  - Humans
MH  - *Fluorodeoxyglucose F18
MH  - Positron Emission Tomography Computed Tomography/methods
MH  - Retrospective Studies
MH  - *Lymphoma, Large B-Cell, Diffuse/diagnostic imaging/therapy
MH  - Prognosis
MH  - Biomarkers
MH  - T-Lymphocytes
OTO - NOTNLM
OT  - CAR T cells
OT  - Fluorodeoxyglucose
OT  - Large B cell lymphoma
OT  - Positron emission tomography
OT  - Prognostic factors
OT  - sDmax
EDAT- 2023/09/18 12:43
MHDA- 2024/01/09 06:42
CRDT- 2023/09/18 11:04
PHST- 2023/05/10 00:00 [received]
PHST- 2023/09/04 00:00 [accepted]
PHST- 2024/01/09 06:42 [medline]
PHST- 2023/09/18 12:43 [pubmed]
PHST- 2023/09/18 11:04 [entrez]
AID - 10.1007/s00259-023-06427-6 [pii]
AID - 10.1007/s00259-023-06427-6 [doi]
PST - ppublish
SO  - Eur J Nucl Med Mol Imaging. 2024 Jan;51(2):481-489. doi: 
      10.1007/s00259-023-06427-6. Epub 2023 Sep 18.